We can't have our cake and eat it - we have to change our (saturated fat) diet
or ration health care

Way back in the 1990s – when I was thin – this girl I knew came out with an idea so extraordinary that I laughed. “There should be extra tax on food containing saturated fats,” said Claire. “To put people off them.” Claire was bright, unworldly and Left-wing; I assumed this was just so much Marxist gibberish, and forgot about it.

Until this week, when a juxtaposition of two stories on a newspaper website made me wonder if she hadn’t been on to something after all.

The first story was good news: medical advances mean that deaths among newborn children from heart defects are 80 per cent lower than 30 years ago.

The Whig interpretation of history turns out to be correct. Man evolves, and so does his technology. From the darkness to the light; from a state of sickness to one of health. Progress is (by definition) inexorable: the more we learn about ourselves, the better the lives we can fashion; “life” being the biomechanical construct which carries that self about.

Next to that story, however, was the Tory rejoinder to such Whiggish optimism: by 2033, we were warned, 75 per cent of Britons will be “struck by obesity-driven illnesses.” Even as thousands of newborn children are saved by medical progress, so millions more of their older brothers and sisters will hasten their own deaths by cramming their arteries with saturated fats. We are fatter than ever and will become fatter still, choosing a future of heart disease, diabetes, and an early grave. Choosing it.

Maybe Claire had a point? Tax the fat(ty foods)? Denmark gave it a go, surcharging foods with more than 2.3 per cent saturated fat in a law introduced in 2011… and abolished in 2012. Whatever the merits of the idea – and deliberately increasing the price of food still makes me squawk with horror – it didn’t work when it was tried.

Maybe we should bully people into changing by shaming them. I’m not the thin boy who laughed at Claire in 1995; I’m pointing at the mirror here. A statin controls my cholesterol levels. I could achieve the same effect by exercising much harder and more frequently, and cutting fat from my diet. (Probably: some people, of course, are genetically susceptible to high cholesterol, for reasons imperfectly understood; they are not amenable to “lifestyle” changes. I tell myself I’m one of them: pull the other one.)

But, as I said to my GP: I’m in my mid-40s. I work long hours. I already exercise a lot. Our diet is pretty healthy, plant-based and scant on saturated fats. How plausible is it that I will embrace a zero-fat diet for the rest of my life, or take up weight-training on top of swimming? The GP agreed: 40mg simvastatin, once a day, take with water before bed.

That doesn’t stop me tutting at the fat schoolkids who line the pavements, shoving grease in their faces. But whether it comes from a fried-chicken bar, or that cake you crave on The Great British Bake Off: it’s fat. Too much will kill you. You know this. Still, one more scone, Vicar? The Whig theory of history, destroyed by Mary Berry.

So taxes don’t work, and nor does New Labour-ish hectoring. Perhaps we must simply embrace our overly-fleshy future. But this, too, would have consequences beyond the early deaths.

Statins are (now) cheap, so I don’t lose sleep over the impact my cholesterol suppression has on the NHS budget. The obese have no such solace: they cost the health service a fortune, more so with each year that passes. “I pay my taxes,” they wheeze. So do we all.

Including, one day, that neonate, born with a heart defect. There won’t be enough money to treat all of us. Perhaps the adult obese should go to the back of the queue; some health authorities already do this.

The reaction to this truth – if we want an NHS, we have to ration healthcare – lies, I believe, behind the pseudo-pathologisation of obesity; the idea that it’s an epidemic, an unknown pathogen flitting through the air, entering our lungs and rendering us hopelessly, helplessly fat. Either that or there is misfiring in your dopaminergic (it’s nearly always dopamine) brain chemistry, which no man could be expected to control.

Here’s Tam Fry, of the National Obesity Forum, to make my point: “The tragedy is that we have brought this on ourselves. We have failed miserably to prevent weight increases for more than two decades, so this problem has kept creeping up on us.”

So far, so good. But he then says: “Successive governments have failed to take a firm strategy on this, and so we are left with this time bomb.”

How I loathe that phrase “successive governments”, suggesting the solution is simple, if only voters would choose insightful people – like the Obesity Forum? – to govern them. Some problems aren’t amenable to legislation. Not in the free world, anyway.

Change our diet, or get real about healthcare rationing. At the moment we want to have our cake and eat it.